ROSACEA

Treatment

• Oracea
  • A formulation of doxycycline which retaines anti-inflammatory properties but has no anti-biotic properties
  • Effective in placebo-controlled trials (FP News, 5/15/06)
• Topical Retinoids
  • Clinical improvement often not seen until after 2-3mos of treatment
  • Start with low doses e.g. tretinoin 0.05% cream, and build up..
• Isotretinoin
• Lasers and light-based therapies
• 251 pts with moderately severe rosacea (10-50 inflamed papules or pustules, persistent erythema, telangiectasias) randomized to azelaic acid 15% gel vs. metronidazole 0.75% gel BID; at 15wks, azelaic acid group had sig. greater mean reduction in # of inflammatory lesions (12.9 vs. 10.7) and also in improvement in erythema (Arch. Dermatol. 139:1444, 2003--AFP).